Long‐term results of the transmanubrial osteomuscular‐sparing approach for pediatric tumors

Madi, Aziz El; Irtan, Sabine; Sauvat, Frédérique; Zérah, Michel; Schleiermacher, Gudrun; Galmiche‐Roland, Louise; Minard‐Colin, Véronique; Brisse, H.; Sarnacki, Sabine

doi:10.1002/pbc.26527

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…As described in other studies, neuroblastoma and other neurogenic tumors were the most common tumor entity [13][14][15]25]. Our cohort included a relatively large number of five malignant rhabdoid tumor patients compared to one previously reported in the literature [25]. The indication for either surgical approach was based solely on the localization of the tumor, as the first descriptors suggest [8,11]: trap-door thoracotomy was performed for tumors located at the cervicothoracic junction or superior mediastinum, and clamshell thoracotomy was performed for posterior mediastinal and bilateral dorsal thoracic tumors.…”

Section: Discussionsupporting

confidence: 64%

“…The patient population studied in this study is comparable in terms of epidemiologic and clinical characteristics to those previously studied. As described in other studies, neuroblastoma and other neurogenic tumors were the most common tumor entity [13][14][15]25]. Our cohort included a relatively large number of five malignant rhabdoid tumor patients compared to one previously reported in the literature [25].…”

Section: Discussionmentioning

confidence: 95%

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Trap-Door Thoracotomy and Clamshell Thoracotomy as Surgical Approaches for Neuroblastoma and Other Thoracic Tumors in Children

Mayer,

Schunn,

Urla

et al. 2024

Cancers

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Solid tumors of the cervicothoracic junction, the posterior mediastinum, or bilateral dorsal thoracic tumors represent a challenge in pediatric surgical oncology. The aim of this study was to evaluate trap-door thoracotomy and clamshell thoracotomy as surgical approaches. A single-center retrospective study of children with solid tumors in these specific localizations was performed. From 2015 to 2023, 26 children (17 girls; 9 boys) were treated at a median age of 54 months (range 8–229). Tumor resection was performed for neuroblastoma (n = 11); metastatic disease (n = 7); malignant rhabdoid tumor (n = 4); Ewing sarcoma (n = 1); inflammatory myofibroblastic tumor (n = 1); rhabdomyosarcoma (n = 1); and neurofibroma (n = 1). The surgical goal of macroscopic complete excision was achieved in all of the 14 children who underwent trap-door thoracotomy and in 11 of the 12 children who underwent clamshell thoracotomy. There were no major complications. At a median follow-up of 8 months (range 0–60), the disease was under local control or in complete remission in 66.7% of the children. In conclusion, surgical resection of solid tumors of the cervicothoracic junction in children can be performed safely and successfully with trap-door thoracotomy and with clamshell thoracotomy for posterior mediastinal or bilateral dorsal thoracic tumors.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 95%

Trap-Door Thoracotomy and Clamshell Thoracotomy as Surgical Approaches for Neuroblastoma and Other Thoracic Tumors in Children

Mayer,

Schunn,

Urla

et al. 2024

Cancers

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“…It is then prolonged with an anterior thoracotomy at the level of the second rib [7,8]. This approach allows a good control of the supra-aortic vessels and nerves through the thoracic inlet and a safe resection of the neoplastic mass [9,10].…”

Section: Resultsmentioning

confidence: 99%

Surgical Approaches to Neuroblastoma: Review of the Operative Techniques

et al. 2021

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Neuroblastoma (NB) is the most commonly occurring soft-tissue malignancy of childhood. Surgery plays an important role in multidisciplinary treatment and its principal aim is a local control of the disease, respecting the integrity of the surrounding structures. There is no unanimous consensus on the best surgical technique, and the operative approach largely depends on the anatomical location and the extension of the mass. To have a complete overview of the different type of treatment, we made a review of the literature from the last twenty years of all the surgical approaches applied for NBs resection, accordingly to the anatomical site.

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“…Primary cervicothoracic neuroblastoma usually arises from the stellate ganglion and progress extending in both directions, upward to the skull basis and downward to the posterior mediastinum. Access to the mass can be obtained through two main, although similar, approaches: the anterior cervical trans-manubrial, involving a lateral cervical incision extended through the midline of the sternum to the second intercostal space as a transverse thoracotomy [ 5 ]; the “trap-door”, consisting of a supraclavicular incision extended through the midline of the sternum to the fourth intercostal space as a transverse thoracotomy [ 6 ]. …”

Section: Surgical Approaches and Anesthesia Considerationsmentioning

confidence: 99%

“…the anterior cervical trans-manubrial, involving a lateral cervical incision extended through the midline of the sternum to the second intercostal space as a transverse thoracotomy [ 5 ];…”

Section: Surgical Approaches and Anesthesia Considerationsmentioning

confidence: 99%

Anesthesia in Children with Neuroblastoma, Perioperative and Operative Management

et al. 2021

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Neuroblastoma (NB) is the most common extracranial, solid, pediatric malignancy and, despite the constant progress of treatment and development of innovative therapies, remains a complex, challenging disease causing major morbidity and mortality in children. There is significant variability in the management of neuroblastoma, partially due to the heterogeneity of the clinical and biological behavior, and partially secondary to the different approaches between treating institutions. Anesthesia takes an integral part in the multidisciplinary care of patients with NB, from diagnosis to surgery and pain control. This paper aims to review and discuss the critical steps of the perioperative and operative management of children undergoing surgery for neuroblastoma. Anesthesia and analgesia largely depend on tumor location, surgical approach, and extension of the surgical dissection. Attention should be paid to the physio-pathological changes on cardiovascular, gastrointestinal, and immune systems induced by the tumor or by chemotherapy. At the time of surgery meticulous patient preparation needs to be carried out to optimize intraoperative monitoring and minimize the risk of complications. The cross-sectional role of anesthesia in cancer care requires effective communication between all members of the multidisciplinary team.

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Long‐term results of the transmanubrial osteomuscular‐sparing approach for pediatric tumors

Abstract: TOSA is a valuable surgical approach for all cervicothoracic tumors with acceptable long-term morbidity when compared with its complexity. We can therefore recommend TOSA for tumors involving the thoracic inlet.

Cited by 10 publications

References 16 publications

Trap-Door Thoracotomy and Clamshell Thoracotomy as Surgical Approaches for Neuroblastoma and Other Thoracic Tumors in Children

Trap-Door Thoracotomy and Clamshell Thoracotomy as Surgical Approaches for Neuroblastoma and Other Thoracic Tumors in Children

Surgical Approaches to Neuroblastoma: Review of the Operative Techniques

Anesthesia in Children with Neuroblastoma, Perioperative and Operative Management

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